2-D Shear Wave Elastography for the Evaluation of Liver Fibrosis in Hepatosplenic Schistosomiasis: Reliability of a Single Measurement and Inter-Hepatic Lobe Variability

Data on liver and spleen stiffness by 2-D shear wave elastography (2-D SWE) in hepatosplenic schistosomiasis (HES) remain scarce. We aimed to assess the correlation between single to multiple measurements of liver and spleen stiffness and to evaluate inter-hepatic lobe variability of liver stiffness measurement (LSM) using 2-D SWE in HES patients. Liver and spleen elastography were performed in HES patients in this cross-sectional study. A total of four stiffness measurements were performed in the right lobe (RL), left lobe (LL), and spleen. The correlation between the first measurement and the median of four measurements was assessed. Liver stiffness measurement of both hepatic lobes was compared. Twenty-six HES patients were included. Liver stiffness measurement was higher in the left than in the right hepatic lobe (17.9 kPa [11.3–92.0] versus 14.9 kPa [5.6–44.4]; P = 0.019). The first measurement was similar to the median of the four measurements for the RL (14.6 [5.6–60.8] versus 14.9 kPa [5.6–44.4]; P = 0.87), LL (17.4 [8.0–128.1] versus 17.9 kPa [11.3–92.0]; P = 0.54), and spleen (50.5 [10.0–157.0] versus 55.7 kPa [19.1–119.4]; P = 0.48). An excellent correlation between the first measurement and the median of four measurements for the RL ( r = 0.93; P < 0.001), LL ( r = 0.88; P < 0.001), and spleen ( r = 0.89; P < 0.001) was observed. In HES, LSM of the LL seems to be higher than that of the right hepatic lobe. Considering the excellent correlation between the first measurement and the median of four measurements in both hepatic lobes and spleen, a single measurement would be sufficient to evaluate liver and splenic stiffness in patients with HES.